Provider Demographics
NPI:1649583972
Name:STOLARICK, BEVERLY MASON (MSW/LCSW)
Entity Type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:MASON
Last Name:STOLARICK
Suffix:
Gender:F
Credentials:MSW/LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 SWALLOW CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-2413
Mailing Address - Country:US
Mailing Address - Phone:919-859-3851
Mailing Address - Fax:
Practice Address - Street 1:1200 SWALLOW CT
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-2413
Practice Address - Country:US
Practice Address - Phone:919-859-3851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-15
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0008421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical